Forms

DO NOT make multiple copies of forms as they are frequently revised to reflect federal, state, and local changes in policy and requirements. Print forms as needed.

Accessible Instructional Materials

Accommodations, Modifications, Supplementary Aids, and Services

• Documentation of Accommodations

Adapted Physical Education

• Screening for Instructional Strategies Adapted Physical Education Form
• Related Services Checklist for Transfer Students (In and Out)

Alternate Curriculum and Assessment

• Alternate Curriculum Decision Making Worksheet
• STAAR Alt 2 Participation Requirements Form (English)
• STAAR Alt 2 Participation Requirements Form (Spanish)

ARD-IEP Committee

• Record of Committee Form
• Students with Disabilities Records Maintenance and Access
• Special Education Eligibility Folder Transfer Form
• IEP Rubric
• ARD/IEP SUPPLEMENT: IEP Review for Course Performance

Assistive Technology

• Related Services Checklist for Transfer Students (In and Out)

Auditory Impairment

• Sign Language Interpreter Request Form
• AI/VI Request Form
• Memo to Principals about FM Units
• FM Units Sample Documentation

Auditory Processing

Autism

• Tiered Autism Team Assistance and Support

Behavior Support

• DAEP Referral Form
• Student Code of Conduct (English, Spanish, Vietnamese)

Cameras in the Classroom

Child Find (Initial Referral)

Commensurate School Day

Confidentiality of Student Records

• Folder Access Sheet
• Consent for Release and Receipt of Information to Access Medicaid Reimbursement (English, Spanish, Vietnamese)
• Procedural Safeguards (English, Spanish)
• Procedural Safeguards HISD Contact Page (Spanish, Vietnamese, Arabic)
• Students with Disabilities Records Maintenance and Access

Counseling and Psychological Services

• Screening for Counseling as a Related Service
• Counseling Evaluation Report Template
• Guidance for Developing Counseling/Psychological Services Plans
• Related Services Checklist for Transfer Students (In and Out)

Determination of FAPE and Compensatory Services

Disability Categories

Discontinuing Special Education Services

Documentation of Supports and Services Provided for Transfer Students on an HISD Campus

Dyslexia

Early Childhood

• Child Study Department - Intake Brochure
• Child Study Department - Chancery SMS Enrollment Request
• Child Study Department - ECI Transition Flowchart
• Compliance with Three-is-Three Timelines - ECI
• Compliance with Three-is-Three Timelines - AI and VI
• Compliance with Three-is-Three Timelines - Non-enrolled Referral and ARD for Head Start

English Language Learners

Extended School Year Services

• ESY Services Consideration and Decision Making Guide
• ESY Services Contact Hour Register
• ESY Services Class List
• ESY Services Closeout Sheet
• ESY Services Consideration and Decision Making Guide
• ESY Services Packet Submission Guide
• ESY Services Progress Report
• ESY Services Summary Sheet for Contact Hours Register
• ESY Services Supplement

Field Trips

Glossary of Terms

Glossary of Terms English to Spanish

Graduation

• Recommended High School Program Exit
• IEP Review for Course Performance

Grade Placement Committee and Graduation

Health and Medical Services

• Related Services Checklist for Transfer Students (In and Out)
• State of Texas Interagency Eye Exam Report
• Documenting Medically Fragile Students

Homebound Services

• Homebound Referral Packet

Inclusive Services

Independent Educational Evaluation

• IEE FAQ
• Outside Evaluation Procedures
• Outside Evaluation Analysis Tool
• IEE Letter to Parent
• IEE Letter to Provider
• IEE Providers - Functional Behavioral Assessment
• IEE Providers - Psycho-Educational
• IEE Providers - Psychological
• IEE Providers - Speech

Identification

Individualized Education Program (IEP)

• Facilitated IEP Process Flow Chart
• Consent for Release and Receipt of Information to Access Medicaid Reimbursement (English, Spanish, Vietnamese)
• Documenting Delivery and Receipt of Relevant Portions of the IEP

In-Home and Community-Based Training

• In Home and Community Based Screener
• In-Home and Community Based Screener Spanish
• In-Home and Community Based Screener Vietnamese
• Related Services Checklist for Transfer Students (In and Out)

Intervention Assistance Team (IAT)

• Procedural Safeguards (English, Spanish)
• Procedural Safeguards HISD Contact Page (

Spanish, Vietnamese, Arabic)

• Standard Script for Explaining FIE (Arabic, English, Spanish, Vietnamese)

Music Therapy

• Music Therapy Screener
• Related Services Checklist for Transfer Students (In and Out)

Occupational Therapy

• Related Services Checklist for Transfer Students (In and Out)

Out of District Programs

• Placement Review Request Form
• Central Placement Review Readiness Checklist
• Out of District Placement Verification Form (Page 1; Page 2)
• Sample Central Placement Review Agenda
• SPED Transportation Application
• SPED Transportation Existing Service Change Request Form
• Central Placement Review (CPR) Schedule (2016-2017)
• Reintegration Goal Progress Documentation Form
• Recommended Reintegration Plan Worksheet Template
• Recommended Reintegration Plan Worksheet Sample
• Referral for Special Education Behavioral Consultation

Parent Concerns

• Parent's Guide to the ARD Process (Chinese, English, French, German, Spanish, Tagalog, Vietnamese)
• Procedural Safeguards (English, Spanish)
• Procedural Safeguards HISD Contact Page (

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Spanish, Vietnamese, Arabic)

• Receipt for Notice of Procedural Safeguards (English, Spanish, Vietnamese)
• Sign Language Interpreter Request Form

Physical Therapy

• Related Services Checklist for Transfer Students (In and Out)

Placement Review and Reintegration

• Placement Review Request Form
• Central Placement Review Readiness Checklist
• Out of District Placement Verification Form (Page 1; Page 2)
• Sample Central Placement Review Agenda
• SPED Transportation Application
• SPED Transportation Existing Service Change Request Form
• Reintegration Goal Progress Documentation Form
• Recommended Reintegration Plan Worksheet Template
• Recommended Reintegration Plan Worksheet Sample

Private, Religious, and Home Schools

• Request for a Disability Evaluation for a Student Parentally Placed in a Private School

Programs and Services

Progress Monitoring and Reporting

Re-evaluations

• Standard Script for Explaining FIE (Arabic, English, Spanish, Vietnamese)
• Release of Medical/Mental/Behavioral Health Information Form (Arabic, English, Spanish, Vietnamese)
• Reevaluation Information Request - Health Information
• Reevaluation Information Request - General Education Teacher
• Reevaluation Information Request - Parents (English, Spanish)

Referral for Initial Evaluation

• Standard Script for Explaining FIE (Arabic, English, Spanish, Vietnamese)
• Release of Medical/Mental/Behavioral Health Information Form (Arabic, English, Spanish, Vietnamese)
• Reevaluation Information Request - Health Information
• Reevaluation Information Request - General Education Teacher
• Reevaluation Information Request - Parents (English, Spanish)

Residential Facilities Monitoring

• FORM 2085FC: TDFPS Placement Authorization - Foster Care/Residential Care
• FORM K-908-2085-E: Designation of Education Decision-Maker

Rules and Regulations

Section 504 and the ADA

• Documentation of Accommodations

Self-contained Program Placement Decisions

• Placement Review Request Form
• Placement Review Readiness Checklist

Social Work Services

Special Education Dispute Resolution Systems Handbook

Speech-Language Services

• SLP Guidelines for Determining Need for Dyslexia Referral - Caseload
• SLP Guidelines for Determining Need for Dyslexia Referral - Speech/Language Evaluations

SPP Data Collection

• Data Verfication
• State Performance Plan Indicator 13: Secondary Transition
• State Performance Plan Indicator 14: Grade 12 Exit
• COSP Data Collection Form

Standards-Based IEPs

Staffing Recommendations

State Assessment

• STAAR Alt 2 Participation Requirements Form (English)
• STAAR Alt 2 Participation Requirements Form (Spanish)
• STAAR A Eligibility Criteria Form (English)

Student Records

• Folder Access Form
• Consent for Release and Receipt of Information to Access Medicaid Reimbursement (English, Spanish, Vietnamese)
• Prior Written Notice to Access Medicaid (English, Spanish, Vietnamese)
• Students with Disabilities Records Maintenance and Access

Surrogate Parent

• FORM 2085FC: TDFPS Placement Authorization - Foster Care/Residential Care
• FORM K-908-2085-E: Designation of Education Decision-Maker
• Foster Parent Eligibility Form
• Foster Parent Training Form

Transition

• CBI/CBVI - Data Collection Form
• CBI/CBVI - Notice of Projected Training Schedule
• CBI/CBVI - Transportation Request
• Notice of Transfer of Parental Rights
• Transition Interview - Parent
• Transition Interview - Student
• Transition Interview - Teacher

Translation and Interpretation

• ARD/IEP Agenda
• Notice of Committee Meeting (Spanish)
• Prior Written Notice (Spanish)
• Sign Language Interpreter Request Form
• Translation/Interpretation Checklist
• Translator Request Form

Transportation

• Related Services Checklist for Transfer Students (In and Out)

Universal Design for Learning (UDL)

• Integration of UDL Principles in Instruction to Develop Expert Learners
• Parent Letter - Accessing Kurzweil Firefly at Home
• User Case: Making digital text accessible for all students
• Integrated Text-to-Speech/Scan-to-Read Feature Match

Visual Impairment

• AI/VI Request Form